Editing Multiple system atrophy (section)

===Initial presentation===
The most common first sign of MSA is the appearance of an "akinetic-rigid syndrome" (i.e. slowness of initiation of movement resembling [[Parkinson's disease]]) found in 62% at first presentation. Other common signs at onset include problems with balance (cerebellar ataxia) found in 22% at first presentation, followed by genito-urinary symptoms (9%): both men and women often experience urgency, frequency, incomplete bladder emptying, or an inability to pass urine (retention). About 1 in 5 MSA patients experience a fall in their first year of disease.<ref name="Bensimon">{{cite journal | vauthors = Bensimon G, Ludolph A, Agid Y, Vidailhet M, Payan C, Leigh PN | title = Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study | journal = Brain | volume = 132 | issue = Pt 1 | pages = 156–171 | date = January 2009 | pmid = 19029129 | pmc = 2638696 | doi = 10.1093/brain/awn291 }}</ref>

For men, the first sign can be [[erectile dysfunction]]. Women have also reported reduced genital sensitivity.<ref name="pmid12671951">{{cite journal | vauthors = Oertel WH, Wächter T, Quinn NP, Ulm G, Brandstädter D | title = Reduced genital sensitivity in female patients with multiple system atrophy of parkinsonian type | journal = Movement Disorders | volume = 18 | issue = 4 | pages = 430–432 | date = April 2003 | pmid = 12671951 | doi = 10.1002/mds.10384 | s2cid = 28102026 }}</ref>